Prepare for Summer Power Outages Prepare to beat the heat this summer! Heatwaves often cause power outages, and learning to prepare is easy. The Ready Campaign offers the following tips:
Make sure you have alternative charging methods for your phone or any device that requires power.
Learn about the emergency plans in your area and locate the closest cooling center.
Build or restock your emergency kit. Include food, water, prescription medicines, flashlight, batteries, hearing aid batteries, cash, copies of important financial documents, and first aid supplies.
Be prepared to stay cool if the power is off for a long time. Consider going to a movie theater, shopping mall, or library that has air conditioning.
For more information on preparing for power outages this summer, click here.
Providing Health Care during Mass Violence Responses In the latest issue of the ASPR TRACIE’s (the Technical Resources, Assistance Center, and Information Exchange from the Office of the Assistant Secretary for Preparedness and Response)Exchange, the challenges associated with providing care during no-notice incidents (e.g., mass shootings) are discussed. TRACIE interviewed health care practitioners and first responders to highlight experiences from the pre-hospital, trauma hospital, non-trauma hospital, and rural hospital perspectives in the hopes that learning more about these real-life experiences will help others to plan (and adjust existing plans) for no-notice incidents. Access previous issues of the Exchangehere.
July Aware Prepare Aware Prepare is a monthly electronic newsletter featuring information on upcoming preparedness-related trainings. These trainings may be provided in one or more of the following formats, including: live webcasts, webinars and in person training; archived webcasts, webinars and on demand eLearning. To view the July 2018 issue, click here.
Active Shooter Planning and Response in Healthcare: Recording Now Available On June 11, 2018, HANYS hosted a webinar on Active Shooter Planning and Response in Healthcare. If you missed it, you may now access a recording and download the session materials here.
Hurricane Seasonal Preparedness The 2018 hurricane season is quickly approaching! We encourage everyone to review FEMA’s Hurricane Seasonal Preparedness Digital Toolkit, a comprehensive resource of valuable preparedness information to share with family, friends and recovery partners. Also - ASPR TRACIE (Technical Resources, Assistance Center, and Information Exchange) has also posted a number of resources that can be helpful to review while preparing for hurricane and flooding events.
NY-Alert: Sign Up Now Situational awareness is very important, and CHCANYS’ EM Team encourages all health centers to sign up to receive NY-Alert system updates. The current NY-Alert system is being upgraded to meet growing demand and better serve its users. The new program will continue to be free and customized to the type of alerts users want to receive, including:
Missing person and Amber alerts
Traffic alerts, including significant highway closures, hazardous material spills and more
Severe weather warnings, watches and marine surf advisories for coastal communities
All current NY-Alert users must register for the new program by June 2018 to ensure a seamless transition to the new and improved system. Those without a NY.gov ID should click here to enroll. Those with a NY.gov ID should click here to enroll. Contact NYAlertSupport@its.ny.gov with any questions.
June Aware Prepare Aware Prepare is a monthly electronic newsletter featuring information on upcoming preparedness-related trainings. These trainings may be provided in one or more of the following formats, including: live webcasts, webinars and in person training; archived webcasts, webinars and on demand eLearning. To view the June 2018 issue, click here.
Save the Dates: EM Virtual Peer Support Meetings Ever since the Centers for Medicare and Medicaid Services (CMS) released the final rule on Emergency Preparedness requirements for 17 provider/supplier types, community health centers have been busy writing emergency plans and implementing policies and procedures. In an ongoing effort to provide New York’s health centers with a forum for posing questions and exchanging ideas and best practices with regard to these requirements as well as other emergency management (EM)-related issues, CHCANYS’ EM Team will soon launch a quarterly virtual online meeting space. All EM leads are invited to join the conversation! Meeting dates and times for 2018-19 are as follows:
July 24, 2018 from 1:00 – 2:00 p.m. – register here.
October 23, 2018 – this meeting will coincide with CHCANYS’ Annual Conference and take place both virtually and in-person. Time and registration information to be released soon.
January 22, 2019 from 1:00 – 2:00 p.m. – register here.
April 23, 2019 from 1:00 – 2:00 p.m. – register here.
All meetings/webinars will be recorded and made available to CHCANYS members. Contact firstname.lastname@example.org with questions or for additional information.
NYC Health Care Coalition Update CHCANYS’ EM Team continues to engage in citywide health care emergency preparedness activities spearheaded by the NYC Department of Health and Mental Hygiene (DOHMH). On May 8, 2018, we attended DOHMH’s Emergency Preparedness Symposium (EPS), followed by the New York City Health Care Coalition (HCC) Leadership Council. Highlights from these meetings that support city-wide health care emergency preparedness integration include:
Emergency Preparedness Symposium Following welcome remarks and an introduction from Dr. Celia Quinn of DOHMH, the program mostly focused on lessons learned from this year’s completed SurgeEx exercise, as well as future iterations of this coalition-wide full-scale surge exercise. Group discussions focused on capacity/capability issues shared by emergency preparedness partners within the coalition.
NYC HCC Leadership Council During the NYC HCC Leadership Council Meeting, which followed the Symposium, 11 network and borough Subject Matter Coalitions gave 15-minute presentations on previous and future involvement and achievements. The meeting concluded with an overview of the upcoming NYC HCC Charter and Governance Board Elections.
To learn more about the New York City Health Care Coalition and citywide health care preparedness activities, contact the CHCANYS EM Team / PCEPN at email@example.com.
Virtual Exercise Opportunity: EARTH EX™ Date: August 22, 2018 EARTH Ex is an international, multi-sector, virtual exercise that will focus on processes and tools to support response and recovery from a long-duration power outage caused by one of the six Black Sky hazards. Using tools developed by the National Information Sharing Consortium (NISC), the exercise will provide participants with a unique opportunity to examine response and restoration postures. To learn more, click here and here.
Recent Measles Exposures in NY and NJ The NYS Dept. of Health recently warned New Yorkers of potential measles exposures in Chemung, Genesee, Niagara, and Livingston Counties (see here and here), with New Jersey's Department of Health following suit. Health centers are strongly encouraged to review infection control plans and procedures. In New York State, the Local Health Department should be notified of any suspected case immediately - click here for a listing of local health departments. In New York City, providers should call 1-866-692-3641.
For County Health Department contact information, click here.
For information on reporting suspect cases to the NYC Dept. of Health and Mental Hygiene, click here.
To reach the NYS Dept. of Health’s Bureau of Immunization, dial 518-473-4437
FEMA National Level Exercise 2018 The Federal Emergency Management Agency (FEMA) leads national-level exercises every two years. National Level Exercise (NLE) 2018 will examine the ability of all levels of government, private industry, and non-governmental organizations to protect against, respond to, and recover from a major Mid-Atlantic hurricane. The scenario involves a major hurricane that makes landfall near Hampton Roads, Virginia, causing severe damage to residences, businesses, and critical infrastructure throughout the Mid-Atlantic. Hurricanes Harvey, Irma, and Maria last fall reinforced our need to prepare for hurricanes, and NLE 2018 will provide a well-timed opportunity to apply lessons from those storms in advance of the 2018 Atlantic hurricane season, which begins on June 1. To learn more, click here.
May Aware Prepare Aware Prepare is a monthly electronic newsletter featuring information on upcoming preparedness-related trainings. These trainings may be provided in one or more of the following formats, including: live webcasts, webinars and in person training; archived webcasts, webinars and on demand eLearning. To view the May 2018 issue, click here.
Integrated Health Systems: Implications for CMS Rule The CMS EP Rule includes a provision for integrated healthcare systems, which consist of multiple, separately certified health care facilities under one parent organization. If a regulated facility is part of an integrated healthcare system that elects to have a unified and integrated emergency preparedness program (rather than have each facility separately conduct its own emergency preparedness program), then each facility and the parent organization must adhere to the integrated health care system requirements outlined in the final rule. This document outlines the information available to health care system emergency planners about the integrated health care system requirements in the final rule.
PCEPN 4th Annual Emergency Preparedness Full-Day Seminar: Presentations Now Available for Download On March 15, 2018, in partnership with the NYC Dept. of Health and Mental Hygiene, PCEPN hosted its 4th Annual Emergency Preparedness Seminar for Primary Care. The presenters at this year's seminar discussed the role that community health centers and other types of primary care facilities can play with regard to response and recovery during and after emergencies and disasters. The Federal Emergency Management Agency (FEMA) has published a summary of its activities in 2017, reflecting on a historic year that included unprecedented disasters affecting more than 25 million Americans -- almost 8% of the U.S. population. Over the course of the year, FEMA supported 59 major disaster declarations, 16 emergency declarations, and 62 Fire Management Assistance Grant declarations across more than 35 states, tribes and territories. The importance of health care preparedness cannot be understated, especially in lieu of very active years like the one we just had.
The program included the following speakers:
Jeff Schlegelmilch, MPH MBA - National Center for Disaster Preparedness, Columbia University
Katharine Logan, RN - Office of Health Emergency Preparedness, NYS Dept. of Health
Leighton Jones, MA - Emergency Preparedness Research, Evaluation & Practice Program, Harvard T.H. Chan School of Public Health
Dana Delgardo, NP and Juancy Rodriguez, NP - Callen-Lorde Community Health Center
Sarah S. Lewis, MPH - Vice President, Health System Services, Greater New York Hospital Association
Alexander Lipovtsev, LCSW - PCEPN
All presentation slides are now available for download – click here to access them.
eBook: The Importance of Social Media in Crisis Communications Ten years ago, social media platforms may have seemed like digital toys for teens and tweens. But today, thanks to the overwhelming adoption of social media use by Americans of all ages, social media platforms have metamorphosed into viable communication channels for credible organizations and entities. To read more about the use of social media in crisis communications, click here.
National Nurse-Led Care Consortium Resource Library The National Nurse-Led Care Consortium (NNCC) is a non-profit organization that supports and advocates for nurse-led care. Its Public Health Preparedness project aims to identify and bolster the public health preparedness of community health centers, including Federally Qualified Health Centers (FQHC), nurse-managed health centers, and retail-based health care centers, by identifying preparedness best practices, building useful tools, and providing training and technical assistance. Its educational efforts include presenting webinars and designing publications with the goal of better enabling health clinics and centers to be able to respond to a pandemic or other public health emergency.
CHCANYS’ own Alexander Lipovtsev had the privilege of participating as a panelist in a recent three-part webinar series focusing on navigating the CMS Emergency Preparedness Final Rule, planning for specific hazards, bolstering health center staff readiness for an outbreak, and understanding and advancing the health center role in local emergency response. For the slides presented during this webinar series and additional resources, visit the NNCC resource library here.
Zika Virus and Emerging Mosquito-Borne Diseases The World Health Organization (WHO) has released a 46-page manual and an associated app designed to assist public health authorities in the WHO European Region with issuing communications in response to possible outbreaks of the Zika virus and other mosquito-borne diseases. Access it here.
Learning from the Flint Water Crisis: Protecting the Public’s Health During a FinancialEmergency Learning from the Flint Water Crisis: Protecting the Public’s Health During a Financial Emergency, a report co-authored by attorneys from the Network for Public Health Law and the University of Michigan School of Public Health, details why shortcomings in the structure and implementation of laws related to public health, safe drinking water, and emergency financial management failed to stop or mitigate the Flint water crisis. Along with key findings, the report provides recommendations to help prevent similar crises from happening in other communities.
50th Anniversary of the First 9-1-1 Call On February 16, 1968, Alabama State Senator Rankin Fite completed the first 9-1-1 call in Haleyville, Alabama and it remains as important today as it was when first introduced decades ago. Calling for help is the first of five steps identified by the Federal Emergency Management Agency’s (FEMA) You Are the Help Until Help Arrives (Until Help Arrives) program that one should take to assist another person in any emergency. To honor the 50 year anniversary of this important national service, take the time to learn the five steps and complete the Until Help Arrives training online.
“Phish” Out of Water: Health Care Industry Lags behind Others in Identifying Scam Emails Many health care workers lack awareness when it comes to discerning phishing emails from legitimate ones, according to Media Pro's 2017 State of Privacy and Security Report. Media Pro surveyed 1,009 health care employees across the United States about their security and privacy awareness and compared the results against a broader sample of respondents in other industries. Overall, 78% of health care employees surveyed demonstrated at least some lack of preparedness to handle common privacy and security risks. Among the broader sample, that percentage was 70%. Half of physicians surveyed scored in the "risk" category, meaning their actions could increase their organization's chance for a privacy or security incident. Only 22% of providers scored in the "hero" category, meaning they know how to identify scams and properly dispose of personal information. The lack of awareness was greater among physicians and other direct health care providers (24% could not identify phishing emails) than non-provider health care workers, such as office workers (8% could not identify phishing emails.)
Workers in the health care industry are particularly behind when it comes to physical security. Nearly a third of those surveyed (30%) took unnecessary risks, such as allowing others to access their office or holding a door open for someone rather than asking for identification, compared with 24% of the general population. Nearly a quarter (23%) of respondents from health care organizations could not recognize the common signs of a malware-infected computer. This figure was 12% for the general population. Taking risky social media actions, such as re-posting a coworker's inappropriate post about a competitor, was seen in 30% of those in the health care industry, compared with 20% of the general population. One reason for the disparity, the authors say, is that training providers regarding Health Insurance Portability and Accountability Act (HIPAA) compliance does not necessarily include education about risks like phishing scams. Read more here. (Source: ECRI Institute)
Emergency Preparedness Webinar Series Join the National Nurse-Led Care Consortium for a three-part webinar series focused on building a culture of preparedness in a health center setting. Primary care association and health center administration and staff responsible for emergency preparedness efforts are encouraged to attend.
Part 3: Understanding & Advancing the Health Center Role in Local Emergency Response Date: March 27, 2018 Time: 1:00 - 2:00 p.m. Health centers can play a crucial role in local emergency planning and response efforts. Panelists from across the country will share their experiences in building health care coalitions and other collaborative opportunities to position health centers for a greater impact in preparedness and response. Register here.
Pediatric Issues in Disasters Click here to access a webinar recorded by ASPR TRACIE during which healthcare professionals share how they integrate pediatric issues in their healthcare preparedness plans, trainings, and exercises.
What We Are Reading? The health sector in the United States would be far better positioned to manage medical care needs during emergencies of any scale by empowering existing health care coalitions to connect community resilience efforts with a network of hospitals equipped to handle disasters, according to a new report by the Johns Hopkins Center for Health Security. The report, A Framework for Healthcare Disaster Resilience: A View to the Future, was released on February 22nd during an event at the National Press Club. The authors offer four recommendations for closing preparedness gaps unique to the US health sector: (1) build a culture of resilience; (2) create a network of disaster centers of excellence; (3) increase support for healthcare coalitions; and (4) designate a federal coordinator for catastrophic health event preparedness. To read more, click here.
FEMA Emergency Management Institute: Weekly EMI e-Forums EMI e-Forums are one-hour, moderated webinar discussion forums that provide an opportunity for EMI and the emergency management community to discuss matters of interest on national preparedness training and exercise. EMI e-Forums facilitate a discussion of whole community-presented best practices. The panel members are whole community, with topics relevant to whole community. These exchanges of ideas are free of charge and available to anyone who wishes to participate. Weekly EMI e-Forums will take place on Wednesdays in March from 3:00 – 4:00 p.m. Upcoming topics include:
March 7: Applying Instructional Design Strategies and Behavior Theory to Household Disaster Preparedness Training
March 14: VOADS and Government: Shared Training Resources
March 21: Incorporating Reusable Learning Objects (RLOs) in Training: How to Use from an Instructional Systems Designer
March 28: Homeland Security Exercise and Evaluation Program (HSEEP): Beyond the Templates
To connect, click here at the time of each forum and enter PIN 107622 to access audio.
The Life Cycle of the Flu While flu season in the U.S. is typically at its worst in January and February, the beginnings of the virus typically start to appear as early as October. While we wouldn’t wish the misery of the flu — sneezing, sore throat, fever and general miserableness — on anyone, if you are one of the unlucky ones to fall ill, there are some things you should know about what’s happening inside your body. Learn more here.
ASPR TRACIE Exchange: Volume 6 - Evacuating Healthcare Facilities The Office of the Assistant Secretary for Preparedness and Response (ASPR) Technical Resources, Assistance Center, and Information Exchange (TRACIE) has released a new issue of its informational newsletter, The Exchange, in which individuals share lessons learned from their recent evacuation experiences. The articles include insights from a broad range of authors, including:
Joshua Weil, Mitch Saruwatari, and Skip Skivington (Kaiser Permanente), who share their personal and professional experiences evacuating a hospital in the midst of the California wildfires;
Federal employees Andy Stevermer, Selena Ready, and Victor Harper, who discuss lessons learned from a federal (dialysis) patient movement perspective after Hurricane Maria;
Bill Numbers of Fresenius Medical Care, who discusses lessons learned from his work with the federal government, clinics, and dialysis patients before, during, and after recent disasters;
Todd Senters of Baptist Beaumont Hospital, wgo shares how staff in his facility worked tirelessly to care for existing patients (and those who were dropped off by helicopter) just prior to having to evacuate due a breach in Beaumont’s water pumps.
Lori Upton of SouthEast Texas Regional Advisory Council, who discusses the coalition’s role in regional healthcare facility evacuation after Hurricane Harvey.
Check out previous issues of The Exchange to learn more about crisis standards of care, cybersecurity, preparing for and responding to no-notice events, disaster behavioral health, and the future of the emergency healthcare field.
Free Individual and Community Preparedness Resources Available from FEMA Renew your preparedness program for the new year with free materials from the Federal Emergency Management Agency’s (FEMA) Individual and Community Preparedness Division, including Community Emergency Response Team (CERT) Training Manuals, Youth Preparedness Curriculum, and other preparedness resources. Here are a few tips to help you with your order:
Use the Individual and Community Preparedness Print Publications form to place orders by email, mail, phone or fax.
Some publications have order limits. If you are interested in ordering more than the limit, provide a brief description regarding your need for the publication.
You must have a registered CERT team to receive publications specifying ‘All Orders Require Approval.’
Are You Prepared for Inclement Weather? From fierce Nor’easter storms along the coast to the intense snow in upstate New York, winter weather is often harsh and somewhat unpredictable. A smart choice is to have a plan and involve your family.
Preparedness: Start by having an emergency supply kit readily available and make sure that everyone in the family knows where it is located. Here is a sample list of items you may want to consider:
battery-operated flashlight, clock, and radio;
First Aid kit;
blanket(s) or mylar blanket(s);
cash in small denominations;
fuel for generators.
Food and Water: It is important to have nutritionally dense food on hand that does not require refrigeration/cooking, and one gallon of water per person per day. A seven-day supply of medication is also recommended. Get your refills early:
whole wheat crackers;
nuts and trail mix;
power bars and granola bars;
canned meat and fish such as tuna, salmon, chicken and turkey;
canned vegetables such as beans, carrots and peas;
Full-Scale Exercise Opportunity for NY FQHCs The NYS Dept. of Health is offering New York FQHCs an opportunity to participate in the statewide full-scale preparedness exercise scheduled for late January / early February. Participating health centers will test their communication plans, as well as their ability to communicate with the Dept. of Health during emergencies. CHCANYS’ Emergency Management Team recently hosted a webinar to introduce the exercise; the recording is available here. If you have not yet signed up to participate but would like to, please email firstname.lastname@example.org.
Winter Weather Preparedness Tips Prepare yourself for the winter weather with these helpful tips from the New York State Office of Emergency Management
Emergency Preparedness Must Reads
How Hurricane Maria Worsened Puerto Rico's Health Care Crisis Now almost three months since Hurricane Maria devastated Puerto Rico, more than a third of the territory’s 68 hospitals are still without electricity and some community health centers are operating without regular power and clean water. This report details the worsening, long-standing economic and health challenges that persist in Puerto Rico and discusses how the storm has exacerbated existing fault lines in the territory's health system.
"123456" Remains Most Common Password in 2017 For the second year in a row, "123456" remained the top password among the millions of clear text passwords exposed online thanks to data breach incidents at various providers. Other terms found on a list of Top 100 Worst Passwords of 2017 are equally as distressing – read more here.
Are You Prepared for a Health Care Emergency? The U.S. Department of Health and Human Services (HHS) hosts a comprehensive national knowledge center focused on emergency preparedness for use by health care, public health, and disaster clinical practitioners. Sign up to receive monthly Express and quarterly Exchange newsletters from the Office of the Assistant Secretary for Preparedness and Response (ASPR) Technical Resources, Assistance Center, and Information Exchange (TRACIE) that highlight new and trending emergency preparedness resources. For more information, click hereand here.
Prepare Your Organization for a Winter Storm America’s PrepareAthon! is a Federal Emergency Management Agency (FEMA) campaign designed to assist households and organizations in discussing and practicing plans and safety measures for improving resilience in the face of specific disasters. Planning and preparation can make a big difference in keeping health centers safe and operational following a disaster. The ability to maintain or quickly reestablish business operations and organizational processes requires a focus on preparedness, advance planning, and relationships with external partners and community leaders. FEMA’s new publication, the Prepare Your Organization for a Winter Storm Playbook, provides tools and resources, including with step-by-step instructions for holding a tabletop exercise. To view it, click here. To learn more about the America’s PrepareAthon! campaign, click here.
Coping After a Disaster After a natural disaster, it is normal to feel sad, mad, or guilty—you may have lost a great deal. Your coping skills may change during periods of crisis and heightened stress, limiting your normal ability to effectively solve problems and cope. Stay in touch with family and friends, find a support network, and talk with a counselor. Getting involved with others can help. If you or someone you know feels like completely giving up or are having thoughts of suicide, get help. Contact the National Suicide Prevention Lifeline: 1-800-273-TALK (1-800-273-8255), or use the online Lifeline Crisis Chat. Those in Puerto Rico may call the Primera Ayuda Sicosocial (PAS) emergency help line at 1-800-981-0023. Both are free and confidential and connect callers with skilled, trained counselors. The SAMHSA Helpline also connects callers with counselors available to discuss anxiety related to disaster. Call 1-800-985-5990 or text TalkWithUs to 66746. Spanish speakers may call 1-800-985-5990 or text HABLANOS to 66746
The Joint Commission Perspectives The Joint Commission is updating its Emergency Management standards in response to the Emergency Preparedness Final Rule issued by the Centers for Medicare & Medicaid Services (CMS) on September 16, 2016. Read more here.
New York DMH Responder: Quarterly Newsletter for the Disaster Mental Health Community The Fall 2017 issue of the New York DMH Responder focuses on the fifth anniversary of Superstorm Sandy and the mental health disaster response lessons that have been learned since that epic event – an all too timely topic given the intensity of the 2017 Atlantic hurricane season that is now wrapping up after impacting numerous communities in the U.S. and beyond. Read more here.
Upcoming Full-Scale Communications Exercise with NYS DOH NYS Dept. of Health is in the process of planning a statewide, full-scale communications exercise. CHCANYS would like to gauge the interest of integrating FQHCs into this exercise in a communication response role. This opportunity would be open to state and city networks alike and would help health centers to meet certain CMS requirements. Please fill out this survey to provide CHCANYS with feedback regarding FQHC survey participation.
CMS Rule: Additional Resources The deadline for meeting all the requirements of CMS’ Emergency Preparedness Final Rule (81 FR 63859), which establishes national requirements for Medicare and Medicaid providers/suppliers (including FQHCs), was November 15th. In October 2017, CHCANYS’ Emergency Management team hosted a four-part webinar series for New York FQHCs on the CMS Emergency Preparedness Final Rule and its requirements. This series of free webinars provided information about the origins and the structure of the Rule, its specific requirements for FQHCs as part of Conditions of Participation in the Medicare program, practical tips for implementation and operationalizing its elements, and specific considerations for New York facilities. All four of these webinars have been archived and are now available for viewing.
FEMA Releases NIMS 3.0 On October 17th, the Federal Emergency Management Agency (FEMA) published National Incident Management System (NIMS), Third Edition. Released fifteen months after the public draft, NIMS 3.0 is the first update of the nation's incident management system since March of 2008. Communities across the nation experience a diverse set of threats, hazards, and events. The size, frequency, complexity, and scope of these incidents vary, but all involve a range of personnel and organizations coordinating efforts to save lives, stabilize the incidents, and protect property and the environment. Every day, various organizations work together to share resources, integrate tactics, and act collaboratively. Whether these organizations are nearby or are supporting each other from across the country, their success depends on a common, interoperable approach to sharing resources, coordinating and managing incidents, and communicating information. The National Incident Management System defines this comprehensive approach and is recommended reading for all those implementing emergency preparedness planning efforts at health centers. To access the document and find out more, click here.
Emergency Preparedness Training Opportunities For a list of upcoming classroom and webcast Emergency Preparedness training sessions in New York State, visit the New York State Health Emergency Preparedness Coalition’s webpage.
NYC DOHMH PCEMP Program The New York City Dept. of Health and Mental Hygiene (NYC DOHMH), Office of Emergency Preparedness and Response (OEPR) will soon launch a new program called the Primary Care Emergency Management Program (PCEMP), which will provide NYC-based FQHCs with free on-site technical assistance to support them in meeting the new requirements for the CMS Emergency Preparedness Final Rule. The program, which will run until June 2018, consists of two educational sessions (Fall/Spring) and one tabletop exercise. The following topics will be covered: risk analysis; policies and procedures; communications plans; and testing and training (exercise). Participating individuals are asked to attend both educational sessions. For more information and to enroll, please click here.
Health Center Volunteer Health Professionals (VHP) FTCA Program The Federal government recently extended liability protections for the performance of medical, surgical, dental, and related functions to Volunteer Health Professionals (VHP) at health centers who have also been deemed as employees of the Public Health Service (PHS). Through this process, VHPs of deemed health centers may receive deemed Public Health Service employment status with associated Federal Tort Claims Act (FTCA) coverage. Effective October 1, 2017, the HRSA Electronic Handbooks (EHB) system will begin accepting applications from sponsoring health centers applying for deemed PHS employee status for volunteer health professionals. In order to request coverage for a volunteer, a supplemental deeming application must be completed, submitted, and approved by HRSA through the EHB. Details regarding application requirements are available in the Program Assistance Letter 2017-06. For additional information, click here.
Hurricane Community Health Fund Established to Bolster Health Safety Net in Texas, Florida Direct Relief has announced the creation of the Hurricane Community Health Fund, established in collaboration with the Texas Association of Community Health Centers (TACHC), the Florida Association of Community Health Centers (FACHC), the National Association of Community Health Centers (NACHC), and the National Association of Free and Charitable Clinics (NAFC). The fund, to be administered by Direct Relief, will be used solely for the benefit of hurricane-affected communities and people – particularly those who have low incomes, lack insurance, and are among the most vulnerable residents – and will be directed to community health centers and free and charitable clinics in Texas and Florida. For additional information about this project, click here. To support relief efforts, visit Direct Relief, Americares, and/or the Texas Association of Community Health Centers.
Important Emergency Preparedness Resources CHCANYS Emergency Management Team continues to monitor the situation in Texas and Louisiana as those communities undergo the devastating floods that Hurricane Harvey brought. We would like to remind our New York health centers about the importance of maintaining and exercising their emergency preparedness plans. Keep in mind that the 2017 Atlantic hurricane season runs from June 1 to November 30.
Review your health center’s emergency management plans to ensure information is current and accurate.
In-Person Emergency Management T/TA Sessions Available to Health Centers in Central NY In 2016 – 2017, CHCANYS’ Emergency Management (EM) Team, with funding from the NYS Dept. of Health, offered in-person training sessions on the basics of emergency management to health centers located in the Capital District, Western New York, Long Island and the Hudson Valley. Beginning in the fall of 2017, these enhanced in-person training/technical assistance (T/TA) sessions will be available to health centers located in the Central New York region. CHCANYS’ EM team will work with the interested health centers to identify/ finalize relevant training content, which may be customized to meet their specific organizational needs. Topics may include, but are not limited to, an overview of emergency management concepts, elements of emergency planning, risk communications, preparedness training and exercises, or other relevant topics as they relate to the CMS Emergency Preparedness Final Rule requirements. If your health center is located in Central NY and you are interested in this training opportunity (or have further questions), please contact email@example.com.
Improve Your Cyber Posture: Beware of “Phishing” Social Engineering Attacks Social engineering is the use of deception to manipulate individuals into divulging confidential or personal information for fraudulent purposes. “Phishing” is conducted through e-mail. Have you ever received an e-mail stating that you must respond immediately, that you have won a prize, or that claims to be tax related? These are all popular phishing email themes, but there are a variety of other tactics used to entice users into clicking malicious hyperlinks. The “WannaCry” attack of May 2017 was one of the most devastating phishing attacks to date, having worldwide impact. Remember that every individual and organization is at risk for phishing attacks ─ a single click of the mouse can put your personal and financial information, as well as your organization’s data, at risk.
Take the following measures to protect your organization and yourself from phishing attacks:
Check the header of work e-mails to see who they are from. Sometimes it will be outside of your organization’s .com or email address or sometimes will be “spoofed” to display your organization’s .com or email address. Click the sender’s name to ensure they can be located within your organization’s global address book (GAL).
Remember: If an offer sounds too good to be true, it probably is.
Do not open attachments from any unknown sender.
Hover over hyperlinks to see if the link preview displays an alternate web address from what it claims.
Never provide credit card or other private information to anyone who emails you and whose identity cannot be confirmed.
Cybersecurity Update CHCANYS Emergency Management Team has been monitoring an international ransomware campaign, referred to as "WannaCry 2.0 or Petya" in the media, that has affected critical infrastructure sectors including healthcare and transportation. If you or your health center have been impacted (either directly or indirectly) by this incident, please contact us at EMTeam@chcanys.org to let us know.
If your organization is the victim of a ransomware attack, US Department Health and Human Services (HHS) recommends the following steps:
If your facility experiences a suspected cyberattack affecting medical devices, you may contact FDA's 24/7 emergency line at 1-866-300-4374. Reports of impact on multiple devices should be aggregated on a system/facility level.
Please share these indicators with HHS' Healthcare Cybersecurity and Communications Integration Center (HCCIC) at HCCIC@hhs.gov as well, to enable further analysis.
Report the incident to your state health department.
CMS Interpretive Guidelines The Centers for Medicare and Medicaid Services (CMS) recently released an advance copy of the final interpretive guidelines and survey procedures that support the adoption of a standard all-hazards emergency preparedness program for all certified providers and suppliers. The final CMS guidance will be incorporated into the State Operations Manual (SOM) within the next several weeks. This guidance also addresses the unique differences of other providers and suppliers and explains in detail what surveyors are looking for when auditing for compliance with new emergency preparedness requirements for providers/ suppliers. For more information and to download relevant files, click here.
Advisory: NYSDOH Cyber Awareness Guidance for Providers The NYS Dept. of Health recently issued a letter providing guidance and recommended informational resources for preventing and responding to cyber disruptions. Access it here.
CHCANYS Participates in Gotham Shield TTX CHCANYS’ EM Team had the pleasure to represent community health centers and primary care providers by participating in the Gotham Shield Recovery Table Top Exercise (TTX) on Tuesday, May 9th and Wednesday, May 10th. Gotham Shield 2017 is a series of exercises that collectively examine the ability of the whole community and all levels of government to prevent, protect against, respond to, and recover from an Improvised Nuclear Device attack. Participants included operational program subject matter experts in health and social services, housing, infrastructure systems, and/or economic recovery. Topics of discussion included operational concerns from a variety of perspective areas, gaps for state and local response and recovery operations, and where federal support would be needed.
Hand Hygiene As part of the Clean Hands Count campaign, the Centers for Disease Control and Prevention has announced a new hand hygiene education course: Hand Hygiene, Glove Use, and Preventing Transmission of C. difficile. This online course offers free continuing education (CE) and covers hand hygiene and glove use recommendations for C. difficile patients; best practices for glove use; and the role of environmental cleaning in preventing the spread of C. difficile.
Here are a few things you can do to continue to make Clean Hands Count:
Complete the new education course and claim free continuing education Click here (use course number WD2703)
Watch and share the new Clean Hands Count video The YouTube link is here, and an alternate link is here.
Order and distribute free Clean Hands Count print materials Order Clean Hands Count stickers, brochures, factsheets, and posters here. Note: CDC’s fulfillment house is able to process a limited number of orders each day. If you see that a particular material is temporarily unavailable, please try again another day.
Real-Time Emergency Alerts on Your Mobile Device During an emergency, alert and warning officials need to provide the public with life-saving information quickly. Wireless Emergency Alerts (WEAs), made available through the Integrated Public Alert and Warning System (IPAWS) infrastructure, are just one of the ways public safety officials can quickly and effectively alert and warn the public about serious emergencies. WEAs are sent by state, local, and tribal public safety officials, the National Weather Service, the National Center for Missing and Exploited Children, and the President of the United States.There are three alert categories: imminent threat, AMBER, and presidential. The alerts look like text messages; however, they are designed to get your attention and alert you with a unique sound and vibration, both repeated twice. WEAs are no more than 90 characters, and will include the type and time of the alert, any action you should take, and the name of the issuing agency. These alerts are not affected by network congestion, and will not disrupt texts, calls, or data sessions that are in progress. Users will not be charged for receiving WEAs, and there is no need to subscribe to them. To ensure mobile devices are WEA-capable, check with your service provider. For more information about emergency alerts, click here.
PCEPN Recognized as a Promising Model Practice by NACCHO The primary care sector is a vital component of healthcare system preparedness in New York City. In 2009, the NYC Dept. of Health and Mental Hygiene’s (DOHMH) Office of Emergency Preparedness and Response partnered with CHCANYS to form the Primary Care Emergency Preparedness Network (PCEPN) model. PCEPN is an extension of CHCANYS’ Emergency Management program in New York City and provides training and technical assistance to its members to help them prepare for, respond to and recover from emergencies and disasters. On March 27, 2017, the National Association of County and City Health Officials (NACCHO) selected PCEPN as a Promising Practice, which indicates that our program exhibits the potential for becoming a future Model Practice throughout the country. NACCHO’s Model Practices Program nationally honors and recognizes outstanding local public health practices and shares the outstanding practices through the Model Practices Database. To learn more about NACCHO and its Model Practices Program, click here.
PCEPN 3rd Annual Full Day Seminar Slides Now Available On March 23, 2017, PCEPN hosted its 3rd annual Emergency Preparedness Seminar for Primary Care in partnership with the NYC Dept. of Health and Mental Hygiene. The main focus of this year's seminar was the newly released CMS final rule for Emergency Preparedness (81 FR 63859) that established national requirements for Medicare and Medicaid providers/suppliers. This much anticipated rule represents a major update of these regulations, setting new compliance requirements for 17 provider/supplier types, including FQHCs and Rural Health Clinics (RHCs).
The program included speakers from:
Technical Resources, Assistance Center, and Information Exchange (TRACIE) by Office of the Assistant Secretary for Preparedness & Response (ASPR)
Federal Emergency Management Agency (FEMA)
Harvard T.H. Chan School of Public Health
Americares, a US-based international relief organization
To download presentation slides from the event and other relevant documents, click here.
CMS Releases Guidance Memo on EP Final Rule On March 24, Centers for Medicare and Medicaid Services (CMS) released a Guidance Memorandum that specifically addresses the training and testing requirement of the Emergency Preparedness Final Rule. The document may be downloaded here.
As a reminder, this EP Final Rule requires17 types of Medicare and Medicaid participating providers and suppliers (including FQHCs) to meet the following four standards:
Emergency plan Based on a risk assessment, develop an emergency plan using an all-hazards approach focusing on capacities and capabilities that are critical to preparedness for a full spectrum of emergencies or disasters specific to the location of a provider or supplier.
Policies and procedures Develop and implement policies and procedures based on the plan and risk assessment.
Communication plan Develop and maintain a communication plan that complies with both Federal and State law. Patient care must be well-coordinated within the facility, across health care providers, and with state and local public health departments and emergency systems.
Training and testing program Develop and maintain training and testing programs, including initial and annual trainings, and conduct drills and exercises or participate in an actual incident that tests the plan.
Additional information about the CMS Rule is available here and here.
Effects of Severe Weather on Behavioral Health When a severe storm is on the horizon, communities focus on safety and emergency response. However, communities must also prepare for and respond to the impact and aftermath of severe weather on behavioral health. SAMHSA has dedicated resources through the SAMHSA Disaster Technical Assistance Center to support communities in delivering effective mental health and substance use responses to disasters. Click here to learn more.
Floods: Be Smart Spring will be here before we know it. Flooding is the most common natural disaster in the United States and can happen anywhere. Prepare for possible spring flooding now before it sneaks up on you. The How to Prepare for a Flood guide explains how to protect yourself and your property from flooding and details the steps to take now so that you can act quickly when you, your home, or your business is in danger. For additional resources, click here.
CMS Crosswalk with Accrediting Organizations The CMS Crosswalk, a product of Yale New Haven Health System Center for Emergency Preparedness and Disaster Response’s (YNHHS‐CEPDR), was created by mapping emergency and disaster related program, policy, communication, training and exercise elements of regulatory and accreditation standards to the CMS Emergency Preparedness Conditions of Participation. Every effort was made to ensure that the mapped regulations and accreditation standards matched as closely as possible. However, this document should be used only as a resource for reviewing and updating healthcare emergency preparedness plans and does not replace existing federal, local, or association guidance. Feedback and recommendations related to the crosswalk should be sent to firstname.lastname@example.org.
COCA: Emergency Preparedness Resources for Clinicians The CDC’s Clinician Outreach and Communication Activity (COCA) Training and Conferences webpage has been updated to include conferences from February 2017 – July 2017. Click here to take a look and to learn about conferences sponsored by CDC, other federal agencies, and COCA partners.
NYS Health Commerce System Communications Drill Yields 89% Response Rate On December 6, 2017, the NYS Dept. of Health conducted the first of two Health Commerce System (HCS) Communications Drills. This drill assessed the response rates of community health centers to confirm receipt of both an e-mail and a phone notification sent through the HCS. The drill targeted the HCS roles of Administrator, BT Coordinator, Emergency Response Coordinator and HPN Coordinator. CHCANYS EM Team will be reaching out to those who did not respond to the first drill, urging them to update their HCS contact information prior to the next one, which is scheduled for the spring of 2017. To update your information, please login to the HCS and verify both your Business Contact Info and your Emergency Contact Info. To confirm your contact info, select “My Content” in the upper right corner of the HCS Home Page, then “Change my contact information.” Be sure to view/update the info on both tabs before submitting any changes. If you require help with your HCS login, please contact the Commerce Accounts Management Unit (CAMU) at 866-529-1890. Questions regarding the drill maybe sent to EMTeam@CHCANYS.org
In Case You Missed It… In case you did not get a chance to view the following webinars when they were originally presented, recordings are now available (click to access):
Emergency Preparedness and Response Training Resources The Centers for Disease Control and Prevention’s (CDC) Clinician Outreach and Communication Activity (COCA) initiative provides timely, accurate, and credible information to clinicians related to emergency preparedness and response and emerging public health threats. It serves a wide range of clinical professionals, including: physicians, nurses, physician’s assistants, pharmacists, paramedics, veterinarians, epidemiologists, public health practitioners, and state and local health department officials. COCA’s webpage for Emergency Preparedness and Response contains information on scheduled and on-demand emergency preparedness and response training resources offered by CDC, other federal agencies, and COCA partners. View it here.
New CMS Emergency Preparedness Requirements Resources Our Primary Care Emergency Preparedness Network (PCEPN) initiative, the city extension of CHCANYS’ Emergency Management program, has recently established a webpage dedicated to CMS Emergency Preparedness Rule materials and support. Click here to visit the page, which contains links to useful resources, such as webinar recordings, documents, and links to helpful websites.
Statewide Full-Scale Exercise Participation Opportunity for FQHCs CHCANYS and the NYS Dept. of Health (DOH) invite FQHCs to participate in “Outbreak Unchecked” (OUREx), a statewide full-scale infectious disease exercise to include DOH, the NYS Office of Mental Health, the Division of Homeland Security, the Office of Temporary and Disability Assistance, the NYS Office of Children and Family Services, NYS hospitals, local health departments, emergency managers, EMS, and NYS nursing homes. This exercise will be held in all four Health Emergency Preparedness Coalition (HEPC) regions of New York State in late February - early March, 2017. Participation in this exercise will fulfill the full-scale annual exercise requirement for FQHCs as per the CMS Final Rule on Emergency Preparedness.
Additional Information About OUREx: Exercise type – Full-scale Exercise duration – 4-5 hours Exercise location – multiple sub-regional Exercise parameters – medical surge, PODS, information sharing and the roles of EMS and EM in a biological event. Mission areas – Mitigation, Response
Objectives: Exercise Objectives may be found here.
If your Health Center would like to participate, please contact email@example.com. Next steps for participation will include attending an informational webinar, which will provide participants with additional information about the exercise.
2017-2022 Health Care Preparedness and Response Capabilities Announced The 2017-2022 Health Care Preparedness and Response Capabilities document, recently released by the Office of the Assistant Secretary for Preparedness and Response (ASPR), outlines the high-level objectives for the U.S. health care delivery system, including health care coalitions (HCCs), FQHCs, and other individual health care organizations and what steps they should undertake to prepare for, respond to, and recover from emergencies. These capabilities illustrate the range of preparedness and response activities that, if conducted, represent the ideal state of readiness in the United States. The document was finalized after the agency reviewed more than 1800 written comments.
GW Center for Cyber and Homeland Security Releases New Report on Proactive Cybersecurity Measures The GW Center for Cyber and Homeland Security has released a report entitled, Into the Gray Zone: The Private Sector and Active Defense Against Cyber Threats. The report was the work of a task force of experts from the technology, security, privacy, law and business communities. While not specifically focused on healthcare, it may help you identify the right questions to consider in order toprotect your health center against a growing threat of cyber-crimes. To access it, click here.
Winter is Here! Whether you are excited about it or not, the winter is here! New York winters, which often bring extreme cold, heavy snow, ice, sleet, and freezing rain, can pose serious hazards. It's important to prepare for winter weather-related dangers and to review your organizational and personal plans. Click hereand here for resources to help you prepare.
Zika Resources ASPR TRACIE has recently updated its collection of resources on the Zika virus. This document, called Zika: Resources at Your Fingertips, includes an overview of public health and health care system considerations and implications that are applicable to professionals in those systems, systems, emergency management stakeholders, and other audiences. In addition, the Centers for Disease Control and Prevention has released an updated Key Messages document containing the most up-to-date, cleared information on the ongoing Zika virus outbreak.
Expanding Domestic Violence Screening and Support at Health Centers Check outFutures Without Violence, a blog post featured by HRSA’s Office on Women’s Health, to learn more about how HRSA-funded health centers are working to address the serious public health crisis of domestic violence.
CMS Releases Emergency Preparedness Final Rule On September 8, 2016, the Centers for Medicare & Medicaid Services (CMS) announced the release of the Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers. This important new rule establishes national emergency preparedness requirements for 17 provider and supplier types (FQHCs are one of them) to ensure adequate planning for natural and human-caused disasters and coordination with federal, state, tribal, regional, and local emergency preparedness systems.
This final rule requires Medicare and Medicaid participating providers and suppliers to meet the following four common and well-known industry best practice standards:
Emergency plan: Based on a risk assessment, develop an emergency plan using an all-hazards approach focusing on capacities and capabilities that are critical to preparedness for a full spectrum of emergencies or disasters specific to the location of a provider or supplier.
Policies and procedures: Develop and implement policies and procedures based on the plan and risk assessment.
Communication plan: Develop and maintain a communication plan that complies with both Federal and State law. Patient care must be well-coordinated within the facility, across health care providers, and with State and local public health departments and emergency systems.
Training and testing program: Develop and maintain training and testing programs, including initial and annual trainings, and conduct drills and exercises or participate in an actual incident that tests the plan.
The rule will go into effect 60 days after publication in the Federal Register. Health care providers and suppliers affected by this rule must comply and implement all regulations one year after the effective date.
Updated Emergency Management Plan Template Available CHCANYS has revised and updated its Health Center Emergency Management plan template. For a preview, click here. If you would like to request a copy, please contact us atEMTeam@chcanys.org.
Fall Weather is Here: Here’s what you Autumn Know! As the days get shorter and temperatures fall, a new round of potential weather hazards is on the rise, including hurricanes, wildfires, intense winds, flooding, droughts, early season snow, and more. Learn about the dangers that these hazards pose and specific actions you can take to stay safe with the following preparedness tips from the National Weather Service.
Regional Training Opportunities Available to Health Center Staff The NYS Health Emergency Preparedness Coalition (HEPC) has released training dates for health centers located in Central New York, the Capital District and the Western Region. For more information, click here.
Regional Training Opportunities Available to Health Center Staff The NYS Health Emergency Preparedness Coalition (HEPC) has released training dates for health centers located in Central New York, the Capital District and the Western Region. For more information, click here.
Beat the Heat - Stay Cool! Stay Hydrated! Stay Informed! During the summer months, all New Yorkers are vulnerable to hot weather hazards. Those residing in New York City, where temperatures can be as much as ten degrees warmer than in surrounding areas, are particularly vulnerable. When you must be outdoors in hot weather, take steps to stay cool and healthy. Cut down on exercise and other hard tasks. Drink two to four glasses of cool, non-alcoholic fluids every hour. Rest often in shady areas. Wear light clothing and protect yourself from the sun with a wide brimmed hat, sunglasses and sunscreen (SPF 15 or higher). Click here to view NYC’s “Beat the Heat” brochure and here for suggestions from the Centers for Disease Control and Prevention.
Active Shooter Planning and Response in a Health Care Setting Active Shooter events at health care facilities present unique challenges; health care professionals may be faced with decisions about leaving patients, visitors will be present, and patients and/ or staff may not be able to evacuate due to age, injury, illness, or a medical procedure in progress. For an in-depth look at a planning and response resource produced by the Healthcare and Public Health Sector Coordinating Council, including information on prevention, law enforcement tactics, coordinated response, and behavioral health support. click here.
Prevent and Mitigate Ransomware Attacks Ransomware is a type of malicious software cyber actors use to deny access to systems or data. The malicious cyber actor holds systems or data hostage until the ransom is paid. Click hereto learn more about ransomware from the Department of Health and Human Services, including ways to protect your networks and steps you should take if you become infected with ransomware.
Emergency Management In-Person Training Offered to Health Centers in Western New York CHCANYS’ Emergency Management Team is happy to announce that the in-person EM-101: Emergency Management for Primary Care Centers course has been extended and is now being offered to health center staff in the Western New York region. This course, suitable for all levels of staff, will provide an overview of the four phases of emergency management, the key elements of an emergency management program and plan, and the role of the health center during emergencies and disasters. If you are interested in bringing this training to your health center, contact EMTeam@CHCANYS.org
HIPAA Privacy and Disclosures in Emergency Situations Persons who are displaced as a result of a severe disaster or an emergency often need ready access to health care as well as the ability to contact family and caregivers. A bulletin originally issued by US Dept. of Health and Human services on September 2, 2005 clarifies HIPAA regulations for sharing patient information in such circumstances. We would like to remind health centers about this bulletin as it the information it contains is still relevant. View it here.
CDC-Sponsored Infection Control Assessments Available for NYC Health Centers The Infection Control Assessment and Response (ICAR) program is a national quality initiative developed and funded by the Centers for Disease Control (CDC) that supports state and local health departments in building infection prevention and control capacity in their jurisdictions. Through the program, the NYC Dept. of Health and Mental Hygiene (DOHMH) will be working with healthcare facilities to complete a CDC-developed Guided Self-Assessment tool designed to identify strengths and potential gaps in their Infection Prevention and Control (IPC) programs. Health centers are invited to participate. The program will enhance health centers’ infection control capacity and provide advice, recommendations and resources. All participation is voluntary and DOHMH’s involvement is non-regulatory. To learn more, click here.
Do 1 Thing: Emergency Preparedness Being prepared for disasters and emergencies can seem like a big job. Many people don't know where to start, so they never start at all. With Do 1 Thing, you can take small steps that make a big difference in an emergency. Do 1 Thing is a free 12-month program that makes it easy for you to prepare yourself, your family, and your community for emergencies or disasters. Participate as an individual or as an organization. For more information, click here.
NYS Health Commerce System In an effort to maintain situational awareness, CHCANYS’ Emergency Management Team reminds health center staff to log in and update contact information on the NYS Health Commerce System (HCS). If you encounter login and/or password problems, please call the Commerce Accounts
Transportation Assistance Levels (TALs) Classifications The CHCANYS EM Team recently hosted a webinar in partnership with the NYS Dept. of Health’s Office of Emergency Preparedness (OHEP) to provide an overview of the classification standards for communicating transportation needs during a planned facility evacuation. This information is most applicable to health centers that operate within shelters or residential facilities. To view the webinar slides, click here or visit the Emergency Management Resources page on the CHCANYS website for more information.
National Incident Command System Training HRSA and other federal agencies require all partner entities to be prepared for an emergency. Part of this preparedness is a familiarization at all levels of management and staff with the National Incident Management System (NIMS). Community health centers have been specifically tasked by HRSA with the development of emergency management programs and ensuring that staff is trained in NIMS.
NIMS is a management program that ensures that all types of response elements can work together during an incident using the guiding principles of interoperability and scalability. The integration of assets during a response is extremely important and has been shown to have a direct impact on the outcome of an incident. Health centers are urged to require staff to be trained in NIMS and to integrate NIMS into their emergency operations plans.
The Federal Emergency Management Agency (FEMA) operates online independent study (IS) training courses that cover NIMS and its various levels. The course list covers many topics in emergency management and is free to all who participate. CHCANYS recommends that health center staff be trained in at least 4 basic NIMS courses (IS 100, IS 200, IS 700, and IS 800). Click here to access them on the web.